Proactive vs Reactionary Care

There seems to be two main groups of patients in my office. The first group always has an appointment scheduled and comes into the office for spinal adjustments on a regular basis, while the other population presents for care when they are in crisis.  These two groups illustrate two different models for healthcare.  The regularly scheduled patients are proactive and present for care to maintain their well-being.  Patients who present only when they are in pain represent care which is reactionary – this is how most Americans utilize healthcare.  Reactionary or crisis care means needing a root canal when flossing, brushing and regular cleanings would have preserved healthy teeth and gums; requiring ER services for any number of life-threatening conditions preventable with good diet and exercise; letting our automobile engines seize instead of regularly changing the oil; or visiting the doctor when back pain is too great to bear.

The Eventuality of Back Pain & Arthritis

Estimates indicate that about 80% of people will deal with significant low back pain at some point in their lives.  And a great many of us will eventually experience arthritis pain and stiffness.  Just witness the huge proliferation in products to treat joint discomfort, low back and arthritis pain as a testament to this expanding problem.  From the New England Journal of Medicine, a review found that a clear diagnosis could not be made in near 85% of low back injury cases^[1].  After careful examination, abnormalities could not be found.  Another study, with emphasis on imaging, determined that 97% of low back pain was mechanical in nature^[2].  Maybe degeneration is not pathological, but normal…

Pain, injuries and accelerated degeneration are the result of biomechanical stress.  Indeed, Wolff’s Law tells us that any bone, subjected to prolonged biomechanical stress will adapt to that stress^[3].  This is the same process that causes premature degenerative changes, osteoarthritis, and loss of joint motion.

How Do We Combat These Changes?

With treatments to resolve structural imbalances and support proper biomechanics.  Chiropractic maintenance care is effective because it allows patients to preserve good spinal biomechanics and smooth, pain-free joint mobility.

We know how to abide by a more sensible, preventative model.  We follow a similar paradigm in the maintenance of our teeth and automobiles.  Unfortunately, our spines are not something that can be replaced.  Start the new year off right and resolve to keep your spine happy and healthy for years to come.

Call Matthews Chiropractic Center today to schedule a spinal biomechanical evaluation and get on the road to wellness.

1. Deyo RA, Weinstein JN.  Low Back Pain. N Engl J Med. 2001 Feb 1;344(5):363-70. [↩]
2. Jarvik JG, Deyo RA.  Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002 Oct 1;137(7):586-97. [↩]
3. “Wolff’s Law.”  Stedman’s Medical Dictionary.  26th ed.  1995.  Print. [↩]

It seems like it’s hard these days to select a dish soap, hand soap or household cleaner that doesn’t tout anti-bacterial properties.  Check the active ingredients and you will likely find triclosan.  This compound is very useful for eliminating germs in hospitals, but many worry that widespread use will hamper its efficacy and contribute to further antibacterial resistance^[1].  For regular household use, antibiotics in these products are unnecessary.  Washing our hands with soap and water alone has been shown to remove dirt and germs alike and is supported by the Mayo Clinic^[2].

Overuse of Antibiotics Leads to Ineffectiveness

Of course, antibiotics have there place and can be invaluable in countering bacterial infections, but increasingly, they are losing their effectiveness.  Stronger and stronger medications are needed as patients and their doctors are faced with growing numbers of antibiotic-resistant superbugs.  Reasons for this problem include, but are not limited to, the unnecessary use of antibiotics in household products, antibiotic prescriptions for non-bacterial infections, and the use of antibiotics in food animals.  Repeated overuse of antibiotics selects for more virulent, drug-resistant strains of the organisms that we are trying to eliminate.

When you shop for hand soap, bath soap, hand lotions, dishwashing detergents, surface cleaners, toothbrushes, linens, towels, children’s toys and more, try to select items that are free of antibacterial agents (and possibly even environmentally friendly).  Sometimes it can be hard to find soaps, cleaners, and household goods untainted by antibacterial agents, but if you look carefully you can find them…

Know Your Food

Now, another place where you might not expect to find antibiotics is in your meat products.  Commercially raised chickens, pigs, cattle, dairy cows, and others contain antibiotics in their feed as part of their normal diet.  Buying locally raised meat and chicken at a local farmers’ market is a good way to avoid antibiotics, as well as, growth hormone and other fillers.  Visit the Matthews Community Farmers’ Market on North Trade Street, in Downtown Matthews, NC for fresh, locally produced free-range eggs, pastured pork, grass-fed beef, produce, and more.  Come shop with your neighbors, support the local community, and save antibiotics for treating bacterial infections.

1. http://www.cdc.gov/ncidod/eid/vol7no3_supp/levy.htm [↩]
2. http://www.mayoclinic.com/health/hand-washing/HQ00407 [↩]

As we all know, sitting is a very common activity at work, just like using a computer (a subject for another day), and it is widely accepted that sitting at a desk the whole day can lead to low back pain, soft tissue, and disc injury^[1][2]. I’ve assembled a list of things that you can do at your desk to make you feel more comfortable while sitting. There is one MAJOR caveat… most of these suggestions only help you AVOID low back pain. If you are already suffering, you may need to stop reading this and visit Matthews Chiropractic Center. This concept points to an integral part of my care, namely patient education, so that patient’s may take part in prevention of future problems.

4 Tips for Desk Jockey Comfort

1. Maintain Good Posture / Ergonomics

Make sure that your back is supported by your chair^[3], Use a foot rest, Make your hips higher than your knees using a stress wedge or tilt the back of the seat slightly higher than the front, If you recline your backrest also tilt the seat backwards^[4].

2. Postural Breaks / Change Position

Take regular breaks from sitting, Get up to stretch and walk every 30 minutes, Change the height of your chair periodically, Do some work standing, Sit on an exercise ball at your desk.

It’s easy to get lost in your work. Some patients set timers that remind them that they should get up and take a walk. Your best work happens when you are relaxed and feel good. Don’t press on when your body tells you it’s time for a break. Do so and you will be better for it.

3. Core Strengthening / Conditioning

Muscles of the back and core fire constantly to maintain stable, upright/sitting posture. Eventually, these muscles can become tired and that makes the back sore and prone to injury. Therefore, strengthening and stretching muscles of the core and deep muscles of the back can help prevent pain and low back injury.

I would recommend starting with 4 exercises that require no equipment:

• Cat-Camel
• Curl-up
• Side Bridge
• Bird Dog

Descriptions of these exercises can be found at the American Council on Exercise website.

4. Chiropractic Care

The dangers of prolonged sitting are well documented. In fact, it has been shown that sitting changes the curvature of the spine and increases pressure in the discs^[5][6]. Chiropractic treatment in my office can help combat the muscular pain and spinal fixation that result from maintaining the spine in stressful postures.

A basic rule of thumb is if it hurts, it needs to move. Drink lots of fluids, take breaks, stretch it out, and as a part of a wellness program get chiropractic adjustments.

Do you have a tip or story you’d like to share about fixing the workplace to better suite your back? Please share them with us.

1. Kyphosed seated postures: extending concepts of postural health beyond the office. Pynt J, Mackey MG, Higgs J. J Occup Rehabil. 2008 Mar;18(1):35-45. [↩]
2. The response of the nucleus pulposus of the lumbar intervertebral discs to functionally loaded positions. Alexander LA et al. Spine. 2007 Jun 15;32(14):1508-12. [↩]
3. Effectiveness of a lumbar support continuous passive motion device in the prevention of low back pain during prolonged sitting. Aota Y et al. Spine. 2007 Nov 1;32(23):E674-7. [↩]
4. Lumbar spine curvature during office chair sitting. Lengsfeld M et al. Med Eng Phys. 2000 Nov;22(9):665-9.
   [↩]
5. Lumbar lordosis. Effects of sitting and standing. Lord MJ et al. Spine. 1997 Nov 1;22(21):2571-4. [↩]
6. Ergonomics of posture–review of various problems of standing and sitting posture. Grandjean E, Hünting W. Appl Ergon. 1977 Sep;8(3):135-40. [↩]

This year at Matthews Chiropractic Center I’ve become a new parent. As a parent, I am acutely aware of the desire to make our children feel well ASAP. I am also cautious of everything that I give to my child to eat, drink and feel better. Readers to this space will remember an early September 2008 posting recommending alternative methods of relieving cough and cold in children under 2 years old (“Choose the spoonful of sugar, but not the medicine”). In that posting I highlighted the FDA’s recommendation to avoid use of OTC cough and cold remedies for children under 2 year of age.

Recent news recommends avoiding over-the-counter cough and cold remedies for children until 4 years of age. The Consumer Healthcare Products Association (CHPA) is an industry group representing the manufacturers and distributors of over-the-counter (OTC) medicines and nutritional supplements. On October 7, 2008, the CHPA announced that leading manufacturers are “voluntarily transitioning the labeling on oral OTC pediatric cough and cold medicines to state “do not use” in children under four years of age.”

If you are still using these remedies in question, please be very careful to follow your pediatrician’s instructions, measure doses correctly, and keep track of when doses are given. To learn about an alternative to OTC cough and cold medications, see the earlier article Choose the spoonful of sugar, but not the medicine.

Matthews Chiropractic Center wants you to stay well. With the upcoming cold season creeping closer you need to be at your best so your downtime is little and recovery swift. We welcome October and the spreading of National Chiropractic Month!

Staying Well is Staying in Flow

Chiropractic is an alternative health discipline which aims to remove interruptions to the flow of normal nerve transmission. The spinal cord is the main pathway for nerve messages to and from the brain. These signals allow our brain to perceive sensations, control our heart, lungs, and other organs and allow us to direct movements of our body. The nerve branches, which bring signals to all parts of the body, exit the spinal cord through holes on either side of the vertebral column. Each of the 26 bones of the vertebral column are separated by discs, which form joints with the vertebrae above and below. These joints are what connect the spine and give it flexibility. The vertebral column also surrounds and protects the spinal cord.

Inhibiting Your Wellness

Should a vertebra move out of alignment, say from trauma, emotional stress or another cause, it is likely that the nerve signals will be compromised. The chiropractic profession believes that this compromise negatively impacts the ability of nerves to carry messages and therefore a person’s health. Likewise, emotional stress, muscle tension, and poor ergonomics can stress the body/spine and also reduce the transmission of normal nerve messages. Chiropractic medicine is based on the belief that the body has an innate ability to heal itself. Chiropractors work to remove impediments to spinal motion and normal nerve transmission to aid the body in self-healing. Chiropractors primarily use adjustments to improve spinal motion. In this way, patients can be relieved of back, neck or joint pain, and headaches without drugs or surgery.

Recognizing Your Health through Chiropractic Care

National Chiropractic Month is a consolidation of two previous observances: Correct Posture Month and Spinal Health Month. Since good posture and proper ergonomics helps to eliminate stress on the body and spine, training to improve and maintain good posture is one of the things I usually stress during treatment. Considering how integral posture and spinal health are to chiropractic, it is very fitting that these endeavors be recognized this month. Poor ergonomics and lack of joint motion today could be the cause of your back pain or headache tomorrow… Call to make an appointment and have your spine checked today!